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      Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in the Middle East and North Africa


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          The zoonotic parasite Taenia saginata utilizes bovines as an intermediate host (causing cysticercosis) and humans as the definitive host (causing taeniosis). The public health burden of T. saginata is assumed to be low, but the economic burden is large, due to the resources utilized in the detection and condemnation of infected carcasses and carcass parts. As part of a collaborative effort to synthesize worldwide epidemiological data on this parasite, we present here the results of a systematic review on the distribution of T. saginata taeniosis and bovine cysticercosis in the Middle East and North Africa (MENA).


          Information on the occurrence and prevalence of T. saginata taeniosis and cysticercosis in the MENA region was obtained through a systematic review of published and grey literature, including OIE reports, published between January 1st, 1990 and December 31st, 2017.


          A total of 63 publications were retrieved across the 21 MENA countries. Taenia saginata taeniosis was reported in 11 of these countries, whereas unspecified taeniosis was reported for a further seven. Microscopy-based prevalence values ranged between 0.02–8.6%. Bovine cysticercosis prevalence estimates based on meat inspection were only reported for Egypt and Israel, with prevalence data ranging between 0.2–20% and 0.1–9.1% for cattle and buffaloes, respectively. The presence of bovine cysticercosis could be confirmed for 10 additional countries through OIE reports.


          Human taeniosis occurrence was confirmed for 86% (18/21) of the countries in the MENA region, although in several of these countries the species responsible was not specified. Religious prohibitions on the consumption of pork and the limited extent of pig farming across much of this region, however, suggest that many reported taeniosis cases are likely to be attributable to T. saginata rather than Taenia solium or Taenia asiatica. There was a paucity of data regarding both the prevalence and economic impact of bovine cysticercosis. More detailed epidemiological data on both T. saginata taeniosis and bovine cysticercosis could be obtained by adopting an integrated “One Health” approach, considering the characteristics (e.g. ecosystem related and sociopolitical aspects) of the MENA region. Compared with more conventional approaches, this could lead to an enhanced performance and cost-effectiveness of surveillance systems.

          Electronic supplementary material

          The online version of this article (10.1186/s13071-019-3339-5) contains supplementary material, which is available to authorized users.

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          Most cited references99

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          Taenia solium taeniosis/cysticercosis in Asia: epidemiology, impact and issues.

          Several reports of patients with cysticercosis from many countries in Asia such as India, China, Indonesia, Thailand, Korea, Taiwan and Nepal are a clear indicator of the wide prevalence of Taenia solium cysticercosis and taeniosis in these and other Asian countries. However, epidemiological data from community based studies are sparse and available only for a few countries in Asia. Cysticercosis is the cause of epilepsy in up to 50% of Indian patients presenting with partial seizures. It is also a major cause of epilepsy in Bali (Indonesia), Vietnam and possibly China and Nepal. Seroprevalence studies indicate high rates of exposure to the parasite in several countries (Vietnam, China, Korea and Bali (Indonesia)) with rates ranging from 0.02 to 12.6%. Rates of taeniosis, as determined by stool examination for ova, have also been reported to range between 0.1 and 6% in the community in India, Vietnam, China, and Bali (Indonesia). An astonishingly high rate of taeniosis of 50% was reported from an area in Nepal populated by pig rearing farmers. In addition to poor sanitation, unhealthy pig rearing practices, low hygienic standards, unusual customs such as consumption of raw pork is an additional factor contributing to the spread of the disease in some communities of Asia. Undoubtedly, cysticercosis is a major public health problem in several Asian countries effecting several million people by not only causing neurological morbidity but also imposing economic hardship on impoverished populations. However, there are wide variations in the prevalence rates in different regions and different socio-economic groups in the same country. It is important to press for the recognition of cysticercosis as one of the major public health problems in Asia that needs to be tackled vigorously by the governments and public health authorities of the region.
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            Neurocysticercosis in sub-Saharan Africa: a review of prevalence, clinical characteristics, diagnosis, and management.

            Neurocysticercosis has been recognized as a major cause of secondary epilepsy worldwide. So far, most of the knowledge about the disease comes from Latin America and the Indian subcontinent. Unfortunately, in sub-Saharan Africa the condition was neglected for a long time, mainly owing to the lack of appropriate diagnostic tools. This review therefore focuses on the prevalence of neurocysticercosis in sub-Saharan Africa, the clinical picture with emphasis on epilepsy, as well as the diagnosis and treatment of neurocysticercosis and its related epilepsy/epileptic seizures in African resource-poor settings.
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              Intestinal cestodes.

              This review summarizes the biology, clinical aspects, diagnosis, treatment and epidemiology for the common and rarer (zoonotic) intestinal cestodes of humans. Mass drug application to eliminate Taenia solium carriers may have only temporary effects on cysticercosis transmission. At least two major world genotypes of T. solium have been identified and greater genetic heterogeneity may occur at the regional level. A new human taeniid T. asiatica has been confirmed which occurs sympatrically with T. saginata and T. solium in Southeast Asia. Coproantigen and PCR tests for Taenia spp. have greatly improved diagnostic efficacy and epidemiological studies. There appears to be an increase in human diphyllobothriasis in Europe, Japan and the Americas. Human intestinal cestode infections are globally primarily caused by species in three genera: Taenia, Hymenolepis or Diphyllobothrium. Sporadic zoonotic infections caused by nontaeniids are usually food-borne or due to accidental ingestion of invertebrate hosts. Intestinal cestode infections generally result in only mild symptoms characterized chiefly by abdominal discomfort and diarrhoea. Most human intestinal cestode infections can be treated with a single oral dose of praziquantel or niclosamide.

                Author and article information

                Parasit Vectors
                Parasit Vectors
                Parasites & Vectors
                BioMed Central (London )
                15 March 2019
                15 March 2019
                : 12
                : 113
                [1 ]Veterinary Research Institute, Hellenic Agricultural Organization Demeter, Thermi, 57001 Greece
                [2 ]ISNI 0000 0004 1776 0209, GRID grid.412247.6, One Health Center for Zoonoses and Tropical Veterinary Medicine, , Ross University School of Veterinary Medicine, ; Basseterre, Saint Kitts and Nevis
                [3 ]ISNI 0000 0004 0417 4147, GRID grid.6203.7, Department for Infectious Disease Epidemiology and Prevention, , Statens Serum Institut, ; Copenhagen, Denmark
                [4 ]Department of Epidemiology and Public Health, Sciensano, Ixelles, Brussels Belgium
                [5 ]ISNI 0000 0001 2069 7798, GRID grid.5342.0, Department of Veterinary Public Health and Food Safety, , Ghent University, ; Merelbeke, Belgium
                [6 ]ISNI 0000 0001 2153 5088, GRID grid.11505.30, Department of Biomedical Sciences, , Institute of Tropical Medicine, ; Antwerp, Belgium
                [7 ]ISNI 0000 0004 1937 0650, GRID grid.7400.3, Institute of Parasitology, Vetsuisse Faculty, , University of Zurich, ; Zurich, Switzerland
                [8 ]ISNI 0000 0004 1936 8470, GRID grid.10025.36, Institute of Infection & Global Health, , University of Liverpool, ; IC2 Building, 146 Brownlow Hill, Liverpool, L3 5RF UK
                [9 ]GRID grid.419369.0, International Livestock Research Institute, ; PO Box 30709, Nairobi, 00100 Kenya
                [10 ]ISNI 0000 0001 2166 9385, GRID grid.7149.b, Centre of Excellence for Food- and Vector-borne Zoonoses, Institute for Medical Research, , University of Belgrade, ; Belgrade, Serbia
                [11 ]ISNI 0000 0001 2069 7798, GRID grid.5342.0, Department of Virology, Parasitology and Immunology, , Ghent University, ; Merelbeke, Belgium
                [12 ]ISNI 0000 0004 0607 975X, GRID grid.19477.3c, Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, , Norwegian University of Life Sciences, ; Sentrum, PO Box 369, 0102 Oslo, Norway
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                : 21 January 2019
                : 25 February 2019
                Custom metadata
                © The Author(s) 2019

                beef tapeworm,bovine cysticercosis,cestode,foodborne parasites,middle east,mena,north africa,taenia saginata,taeniosis


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